Overall
GPA
Bemidji State University
Bemidji, MN 56601-2699
Catalog
Year
St. Teaching Semester/Year
Fall / 2016
STUDENT TEACHING REQUEST FORM
Name: (Last)
(First)
Date:
(Maiden)
Local Address:
City/State/Zip
Phone:
Home Address:
City/State/Zip
Phone:
ID #
BSU E-mail
CHECK EACH AREA IN WHICH YOU WILL SEEK TEACHING LICENSURE UPON COMPLETION OF YOUR PROGRAM:
K-6 Elementary Ed
Kindergarten-12
___ Social Studies endorsement
___ Preprimary endorsement
___ Math endorsement
___ Comm/Arts & Lit. endorsement (English)
___ Science
Special Ed K-12 Graduate
___
EBD
___
5-12:
___ Physical Education
___ DAPE
Music
___ Instrumental and classroom
___ Vocal and classroom
___ World Language Spanish
LD
___
___ Health Education
___ Math
___ Comm/Arts & Lit (English)
Science
___ Life Science
___ Earth & Space
___ Physics
___ Chemistry
___ Social Studies
Autism
Place the term/year next to the course number you will have successfully completed before you begin student teaching. (This list
does not represent a complete list of requirements for licensure.)
FOR ELEMENTARY STUDENT TEACHERS ONLY:
FOR SECONDARY AND SPECIAL FIELD
STUDENT TEACHERS ONLY:
ED 3100
Intro to Foundations of Education
ED 3110
Educational Psychology
ED 3140
Human Relations in Education
ED 3350
Pedagogy: Planning for Instruction
ED 3780
Adaptation and Management
ED 4799
The Professional Teacher
HLTH 3400
Health and Drugs in Society
ED 4737
Content Area Reading
ED 3100
ED 3110
ED 3140
ED 3350
ED 3780
ED 4799
HLTH 3400
ED 4820
MATH 1011
MATH 1013
ED3201
ED 3202
Intro to Foundations of Education
Educational Psychology
Human Relations in Education
Pedagogy: Planning for Instruction
Adaptation and Management
The Professional Teacher
Health and Drugs in Society
Student Teaching
Math for Elem. School Teachers I
ED 3203
ED 3221
ED 3222
Ed 3240
Language Arts III
Math Methods
Science Methods
Social Studies Methods
List choice of towns (3) in order of preference:
ED 3301
Creative Expressions
2.
ED 3302
Creative Process Foundations
3.
HLTH 4100
PHED 4200
Health Methods
Physical Education Methods
MTLE/ACT
Math for Elementary School Teachers II
Bemidji State University
Language Arts I
Language Arts II
Basic Skills Scores:
Reading _______
1.
Writing _______
Math _______
Elementary Students - Choice of Grades:
High School Diploma from (School and town) and year:
List all grade levels at which you have completed in-class field experiences:
List any special conditions:
Oct. 2015